IPACHTE#A-J--ay3 7Y Harnett County Department of Public Health 25992
ISSIIFD Tn ~~T m ~C, f lJca~ ~c~ utantutanu L'~-~-k~. `r -4 :i_ r
NEW C' REPAIR ❑ , EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: Y~ 60
Proposed Wastewater System T~~PPe: Ze4 -
Projected Daily Flow: -1 bG GPD
Number of bedrooms: -7 Number of Occupants: G max
Basement ❑Yes 210
Pump Required: ❑Yes ~ ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑ Community ~ublic ❑ Well Distance from well feet Permit valid for. eve years
Permit conditions: ❑ No expiration
Authorized State Agent: Date: tr~Z[? SEE ATTACHED SITE SKETCH
The issuance of this permit b e Health epartme o way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .19S4, .1955, 1956, .1951, AS& and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached system layout.
ISSUED T0: c~ef1 PROPERTY LOCATIOrCt~
SUBDIVISION ~f K~ 4 LOT #
Facility Type: , Rl"New ❑ Expansion ❑ Repair
Basement? El Yes El--No Basement Fixtures? P Yes No
Type of Wastewater System** (Initial) Wastewater Flow: GPD
(See note below, if applicable y
C2 oCJtL4 (Repair)
Installation Requirements/Conditions Number of trenches -3
Septic Tank Size gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
& c' r 1
4~ O-lcC-l:
Improvement Permit
A building permit cannot be issued with only a9, rovement P rrm
PROPERTY LOCATI o W
Exact length of each trench rO feet Trench Spacing:. 2 Feet on Center
Trenches shall be installed on contour at a Soil Cover. 16 inches
Maximum Trench Depth of: 0 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
GPM inches below pipe
Aggregate Depth: inches above pipe
d"yr~" inches total
uJ-f b-'t'~- A wr4-
understand the system type specified it different from the type rpeci6ed on the application. l accept the .rpec16cations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent: "~7 le Date:
Construction Authorization Expiration Date:
HTE# /c, -,r- Permit #
Harnett County Department of 1"Lublic Health
Site Sketch
PROPERTY LOCATON:
ISSUED T0: SUBDIVISION 1` o LOT # C~
Authorized State Agent: z..~..~.~...._ Date:
,7-
/c,c,
s'
i T's- - I
I
rf'~
6,-,, c4
Department of Environment, Health and Natural Resource,
Division of Envimnmental Health
On-Site Wastewater Section
SOIIJSITZ EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949):
Location of Site: Prop, Recorded:
Water 3upptj . Qfubfic ❑ Individual ❑ Well
Evaluation Method: uger Boring ❑ pit
Type of waslawater: sewage ❑ Industrial Process
Shed:
Property ID:
Lot M:
File N:
Code:
Property Size:
❑ Spring ❑ Other
cut
mixed
P
R
0
P
SOIL MORPHOLOGY
all
[
L
.1940
L
i
.1941
PROFILE FACTORS
sapt
ax
Horizon
.1941
9
N
Position)
Slops %
Depth
00
.1941 .1941
3t
w
Sod
1043 .1936
.1944 hwb
rnattt
Consistews
Texit" Minrrsb
Webmw
Color
Soil 3"M
M
Rear Cho
2AL
City
Horst. A LTAR
J-
-1- V-
pdou Repdr system Othar Factors (.1946X
9 atsm
vsita6lo 9 a .1943 Site ClamBcadon (.1948X
A
'em s at Evslialed By: 67-
3itt LTAA r Others Prewt /i, -